Evaluating Bone Health in Egyptian Children with Forearm Fractures: A Case Control Study

El-Sakka, Abeer S; Penon, Cristina; Hegazy, Adham; El-Batrawy, Salwa Reda; Gobashy, Amr; Moreira, Alvaro

doi:10.1155/2016/7297092

Cited by 13 publications

(4 citation statements)

References 40 publications

(38 reference statements)

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“…Vitamin D deficiency and low BMD have been linked to an increased fracture risk in children 22,23. Vitamin D levels are also associated with a higher risk of more severe fractures, such as open or displaced fractures, potentially requiring surgical intervention 24.…”

Section: Resultsmentioning

confidence: 99%

“…Vitamin D deficiency and low BMD have been linked to an increased fracture risk in children. 22,23 Vitamin D levels are also associated with a higher risk of more severe fractures, such as open or displaced fractures, potentially requiring surgical intervention. 24 Compression sided femoral neck stress fractures were studied in a small cohort of patients under 10 years of age showing a lower than expected BMD on DEXA scan.…”

Section: Pediatric Traumamentioning

confidence: 99%

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What Is New in Pediatric Bone Health

Beck

Mahan

Nowicki

et al. 2021

Journal of Pediatric Orthopaedics

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Section: Resultsmentioning

confidence: 99%

Section: Pediatric Traumamentioning

confidence: 99%

What Is New in Pediatric Bone Health

Beck

Mahan

Nowicki

et al. 2021

Journal of Pediatric Orthopaedics

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“…El Sakka et al. 57 did observe that vitamin D deficiency was two times more prevalent for fracture compared to a non-fracture group. This observation is consistent with Chapman et al.…”

Section: Discussionmentioning

confidence: 97%

Multiple fractures in infants who have Ehlers-Danlos/hypermobility syndrome and or vitamin D deficiency: A case series of 72 infants whose parents were accused of child abuse and neglect

Holick

Hossein–Nezhad

Tabatabaei

2017

Dermato-Endocrinology

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Objective: To increase the level of awareness that Ehlers-Danlos/hypermobility syndrome (EDS) and vitamin D deficiency are associated with infantile fragility fractures and radiologic features that may be mistakenly reported to be caused by non-accidental trauma due to Child Abuse and Neglect (CAN).Patients and Methods: We constructed a case series, the largest to date, of infants with EDS who were vitamin D sufficient, insufficient and deficient and infants without EDS but with documented vitamin D deficiency and radiologic evidence of rickets who presented with multiple fractures originally diagnosed as being non-accidental and caused by child abuse. These infants were referred to the outpatient Bone Health Care Clinic at Boston University Medical Campus over a 6-year (2010–2015) period. We also present 6 index cases in which the court concluded that there was no convincing evidence of child abuse and the infants were returned to their parents. Institutional Review Board (IRB) approval was obtained.Results: We present 72 cases of infants with multiple fractures diagnosed to be caused by non-accidental trauma. All infants were younger than one year of age. Among them, 93%(67) had clinical evidence of EDS and/or a family history with a confirmed clinical diagnosis of at least one parent having EDS and the other 7%(5) without evidence of EDS had vitamin D deficiency/infantile rickets. Three of the EDS infants were diagnosed as osteogenesis imperfecta (OI)/EDS overlap syndrome. The most common fractures noted at diagnosis were ribs and extremity fractures (including classic metaphyseal lesions). Serum levels of 25-hydroxyvitamin D [25(OH)D] were reported in 48 infants (18.0 ± 8.5 ng/ml) and in 30 mothers (21.3 ± 11.7 ng/ml). Sixty-three percent (27) of the EDS infants who had their serum 25(OH)D measured were vitamin D deficient 25(OH)D<20 ng/ml and 5 were vitamin D sufficient 25(OH)D>30 ng/ml. The mean serum level for infants with vitamin D deficiency/rickets was (10.2 ± 3.0 ng/ml)Conclusion: EDS, OI/EDS and vitamin D deficiency/infantile rickets are associated with fragility fractures in infants that can be misinterpreted as caused by non-accidental trauma due to child abuse.

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“…Moreover, 27% of them had serum levels under 7 ng/mL. The authors suggested not only vitamin D administration but also fortification of food with vitamin D for the pediatric population [ 34 ]. In Egypt, El-Sakka A et al measured serum levels among children with forearm fractures and noted low bone mineral density along with vitamin D deficits [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

Vitamin D—A Risk Factor for Bone Fractures in Children: A Population-Based Prospective Case–Control Randomized Cross-Sectional Study

Herdea

Ionescu

Dragomirescu

et al. 2023

IJERPH

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Background: Vitamin D is an essential component in calcium metabolism. Seasonality, advanced age, sex, dark skin pigmentation, and limited exposure to sunlight were reported as causes of vitamin D deficiency. This study aims to determine whether children with lower levels of vitamin D suffer more fractures than those with sufficient levels. Materials and Methods: Our institution underwent a prospective case–control randomized cross-sectional single-blinded study that included 688 children. They were split into two groups: the study group and the control group. The study group received supplements of vitamin D and calcium for 6 months. Another reference cohort was observed, which comprised 889 patients in the pediatric ward for different respiratory or gastroenterological conditions without a history of fractures. This group was used for age–sex matching tests. Results: Logistic regression showed that with every one unit increase of vitamin D level, the chance of having a middle third fracture in both bones of the forearm decreased by 7% (OR 1.07); distal third fracture incidence decreased by 1.03 times; middle third radius fracture incidence decreased by 1.03 times; distal third radius fracture incidence decreased by 1.06 times. The risk of having a distal third both-bone forearm fracture increased by 1.06 times with every year of age. Comparing the healing process, we noticed an improvement in bony callus formation for patients in the study group. Conclusions: Dosing the serum level of 25-OH-vitamin D should be taken into consideration for pediatric low-energy trauma fractures. Supplementing with vitamin D and calcium throughout childhood can be a solution for healthy bones. Our preliminary results show that the normal level of vitamin D in children should start at 40 ng/mL.

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Evaluating Bone Health in Egyptian Children with Forearm Fractures: A Case Control Study

Cited by 13 publications

References 40 publications

What Is New in Pediatric Bone Health

What Is New in Pediatric Bone Health

Multiple fractures in infants who have Ehlers-Danlos/hypermobility syndrome and or vitamin D deficiency: A case series of 72 infants whose parents were accused of child abuse and neglect

Vitamin D—A Risk Factor for Bone Fractures in Children: A Population-Based Prospective Case–Control Randomized Cross-Sectional Study

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